FAQ #3 - about Step 3, program directors, extra-curricular activities, MoH, and duration

1. Did you complete Step 3 and then proceeded to apply to the US? Is it mandatory to finish Step 3 as an IMG to improve your chances of securing a place?
I did not complete my Step 3. It is good to have Step 3, especially if you have low Step 2 CK scores. It also does improve your chances.

2. Do the directors look at your Step 1 score ONLY or do they also consider your medical school transcript?
Well, this depends on the program directors. Most will only look at your Step score as they would never have heard of your medical school before. Plus, it is hard to standardize a foreign medical school from India vs one from Brazil – for example.

3. Does extracurricular activities play an important role? I do not hold any significant positions at my university. I love volunteering and such I do a lot of volunteering. Will a good Step 1 score help mask this area?
Step 1 score is definitely the main factor. This is because usually when US med students apply, they will only have their Step 1 score, and not Step 2 (they apply at the start of their 4th year). Extra things other than your score will just help you make you “unique” among other applicants. If they want to compare two applicants with equal step 1 score, then they will look in other areas such as volunteer activities.

4. Is a publication important? At my university, we have US graduates coming to talk to us about their experience and they stress the importance of publishing a paper. This is quite tough, as I am not aware of such opportunities to participate in research as undergrads. May I know if you have published anything and could you tell me how I would go about with obtaining a position?
I did not publish any paper before getting a position. Yes, research indeed will help improve your chances of getting in, especially if you have a lower Step score, or if you are aiming for a University based program.

5. Will it be possible for me to come back to Malaysia with a US residency degree and work with the government sector?
Absolutely. There are many US-trained specialist already practicing in University Malaya Medical Center and UKM Medical Center. Do keep in mind that you can even come back to work even if you quit housemanship midway. When you work with UM or UKM, you are hired by the MoHE, not the MOH. If you have not quit housemanship halfway, you can apply to the MOH. You can also apply to the MOH if you quit halfway, but you will rejoin under the contract basis. Most specialist trained overseas will want to work in UM or UKM only though.
Also take note that most Malaysians trained in the U.S. usually head directly to Singapore or Australia. Many will also just continue staying in the U.S. Depends on what are your priorities.

6. Do I have to wait a long period after graduation and before obtaining a place in the States? Could you tell me the duration, is it around 1 and ½ years? How long did you have to wait after you graduated and till you start your residency program?
It depends on whether you have completed your USMLE Steps, and how fast you can prepare for it. Every year, residency application opens in September. If you miss the boat, you will have to apply the following year. It is best you plan your strategy depending on which month you graduate from medical school.

FAQ #2 - about observerships, finance, and Kaplan

Question from SS

1) I have just passed my first week in Year 3, with no prior knowledge or prior experience in USMLE syllabus. Will it be too late for someone like me to just to start preparing?
It is never too late to start preparing. However, you need to be disciplined and commit your time and energy in it. It is no “walk in the park”.

2) May you share your study schedule with me (inclusive of your study time for your University's syllabus)? How many months will it take with intense maximum preparation to finally sit for Step 1?
I studied it part time, alongside my university’s syllabus. It took me about 4-5 months of about 5-6 hours per day to prepare for my Step 1.

When is the USMLE exam held? When should I register for Step 1?
You can register for the Step 1 anytime, and the exam runs all year round. This means that any week of the year, there may be someone taking the exam in KL. Now, the thing is that you need to “book a seat” in the KL test center. You can only book a seat after registering for the exam. I would suggest you register about 3-5 months before the date you want to take the exam.

3) About observership in US, can you get it if you're just a med student?
If you are a medical student, you can get an elective seat. Observership positions are for those who already graduated.

4) I'm currently a self-sponsored medical student and PTPTN is not doing much help either. Still actively hunting for loans and scholarships so finance is an issue for me. How much did you spend for your preparation for:
a) Step 1 alone
b) Step 1, Step 2 CK & CS.
For Step 1 and Step 2 CK, I spent money for (1) Study materials, (2) Online Question Banks, (3) Exam fees. It would be about USD$900-1000 for each step.
For Step 2 CS, you need to spend money to travel to the U.S., stay for a few days, and take the exam. In total, I would say about USD$3000-4000 – from exam fees, to flight, to accommodation and travel.

5) Should I purchase a recent version of Kaplan Lecture Notes? Should I began with Kaplan or FA? Do you still have stock for the Kaplan Lecture Notes series?
Currently, the most recent Kaplan Lecture Videos is the 2009 version which you can get from Rachel. The most recent Kaplan lecture note is the 2012 version, but it is actually no different than the 2009 version as well – other than how they arranged the chapters. You will need to ask about the lecture notes from Rachel.

Dr. Pagalavan's USMLE post

Recently on Pagalavan.com, there was a post on how medical schools in Malaysia are planning to host USMLE courses. Most certainly there would be a nominal fee for students to undertake these courses. However, I highly doubt that these courses would be successful, because not everyone can be teaching USMLE. You will need expert faculty members from the U.S., who have served in the board which determines what kind of questions are on the USMLE examinations, and how to tackle them.

As such, my personal opinion is that it is better and cheaper for you to get the Kaplan video lectures than attending these USMLE courses. Melaka-Manipal recently tried conducting one for almost RM 15,000.

If you would like to find out more about how to prepare for the USMLE exams, please do refer to the topics I have written in the past.

To all of you who are currently studying for the exam, keep on working hard, and don't give up. The journey may seem long and hard, but if you persevere, it will all be worth it in the end.

- Jamie-

Results of the 2013 NRMP Match (What are my chances)

- by Jamie

I have been requested by Lau (one of our commentators) to provide information on the 2013 Match results which just concluded recently.

The match process is where all the applicants for the residency position in 2013 will know if they get a spot or not, and also where will they be heading. In the U.S., all residents begin the same in July. There is only one "intake" per year. This is to ensure a structured education environment, where everyone starts work at the same month, and their progress is monitored over the next 3 years. This is unlike the system we have in Malaysia, where house officers start all year round, and is not really monitored as they go through their training.

The NRMP (National Residency Matching Program) released the results of the 2013 match. I will just touch on a few specialties which are popular among Malaysians.

Internal Medicine
There are a total of 6,227 internal medicine positions available. 50% were filled by US-graduates, and the other 50% were filled by foreign graduates.

General Surgery
There are 1,185 general surgery training positions available. 80% were filled by US-graduates, and 20% were filled by foreign graduates. Other than that, there were also 1,278 preliminary (1 year) surgery programs available. 35% were filled by US-graduates, and 65% were filled by foreign graduates.

Pediatrics
There are 2,616 pediatric training positions available. 70% were filled by US-graduates, and 30% were filled by foreign graduates.

These numbers may seem confusing, but in simple numbers, how many foreign grads got a training position in total? About 7,000 foreign grads from all over the world.

This year (2013), foreign graduates were more successful than previous years. The match rate increased by 7%.

Many various sources will discourage your pursuit by making statements out of the air. I am only here to show you the truth based on solid facts. You can refer to the match statistics yourself. I have included the data below.

Data : http://www.nrmp.org/data/advancedatatables2013.pdf, http://www.nrmp.org/pressrelease2013.pdf

FAQ#1: regarding the technicalities of USMLE exam

- by Jamie

Some questions which I received from Dr.N :

1) Yesterday i've already go to the ecfmg website  and signed up for an account in order to obtain an id, which i was informed maybe takes around 5 days. But what i want to know is, is expiry date applied for the id or password? because i still have to wait for a few month to go from now to register for the exam, as i only will be able to pay for the test after i start to work  by end of this april or may. If an expiry date applied, how long does it lasts?
As far as I know, obtaining the USMLE ID need not be followed immediately by registration for exam. So don't have to worry about this.

2) Just like you explained earlier, usmle consist of three steps, and what if someone fail one of the step, for example if someone has already passed excellently in step one, but he/ she did'nt do well in step 2, so should he/she just repeat the step 2 only or repeat the whole stuff?
The thing with the USMLE is that you shouldn't take the exam if you don't feel prepared. This is what the American board has decided. The most foolish thing to do is taking the exam when you are not prepared. Hence, if you pass it, the score sticks with you for the rest of your life, whether it is good or bad. You only get to resit the USMLE if you fail the exam. However if you fail, there will already be a mark in your USMLE transcript.

3) ..and how long is the time gap between one step and another?
You need to take the Step 1, Step 2 CK, and Step 2 CS within 7 years of each other.

4) I also want to know if there is any coach center for the usmle candidates in malaysia or it just totally a self-prepared  examination?
Melaka-Manipal recently tried hosting USMLE course preparation. They charge about RM 14,000 for the Step 1. You can also try signing up for the original Kaplan course online - which will cost you about RM 6,000 per step.

5) Where can i get the u world question or bank question? is it available in any book stores?
USMLE World is an online question bank. It consist of 2000+ questions, with amazing explanations. What makes it so special is that they format the style of the questions exactly like the real exam. The font, the colour of the background, the highlighting and crossing mechanisms, the calculator function and everything else, follows the ACTUAL format in the real exam. In fact when you take the real exam on your test day, it would feel like just another day of doing questions in USMLE World.

6) My next question is that i was told, for the test registration, there are two ways, online registration and offline registration. the offline registration i must get my medical school to make it for me. Can you give me a detail about this?
What I know about this is that recently, the ECFMG has made it such a way that medical schools can register for it online. However, this requires your medical school to be part of the EMSWP - some fancy web portal for medical schools. The traditional way of registering for the exam is via the "offline" method, where you print and fill up the documents, send it to your medical school, and have them mail it to the U.S. If you want to know more about registering for the exam, you need to read this from certain USMLE forums, or just go through the extensive data in the USMLE website.